Consultant Specialties

HC Deb 16 May 1995 vol 260 cc133-5

2. Rev. Martin Smyth

To ask the Secretary of State for Health if she will make a statement on the shortage of staff in consultant specialties in the health service. [22852]

The Secretary of State for Health (Mrs. Virginia Bottomley)

In the five years to 1993, the number of hospital consultants in England increased by an average of 3 per cent. a year, well above the target of 2 per cent. set in 1987. Over the same period, the number of consultants in Northern Ireland increased by 12 per cent. The Government have established effective mechanisms to ensure that consultant numbers continue to expand to meet demand.

Rev. Martin Smyth

If the Government are controlling numbers to meet demand, why are there continuing shortages, particularly among anaesthetists and paediatricians, which mean that operations have been cancelled? Is someone in the Department using new maths and not counting correctly? Is it job protectionism, or are hospitals saving money at the cost of patient care?

Mrs. Bottomley

I explained that there has been a substantial increase in the number of consultants, but there are always times when there is particular pressure on certain categories. That is why we have set up a working arrangement with the professions, whereby one committee can monitor and anticipate where there is particular pressure. The hon. Gentleman will be pleased to know that, for example, in paediatrics there was a 5.5 per cent. increase in consultants and in accident and emergency there was a 6.7 per cent. increase. The increase has been above average in both those specialisms.

Mrs. Roe

Will my right hon. Friend confirm that the Government are committed to increasing the number of medical students and have taken on board the recommendations to that effect by the Medical Workforce Standing Advisory Committee? Will she also comment on the training of doctors? Can she say anything further about the implementation of the Calman changes?

Mrs. Bottomley

I can indeed inform my hon. Friend that, having not only published the first report of the Medical Workforce Standing Advisory Committee but acted on it, we shall shortly produce the second standing advisory committee report. We train about 500 more medical students a year than we did 10 years ago and we anticipate further increases. My hon. Friend referred to the important Calman proposals to improve and accelerate specialist training. We are working on their detailed implementation, from which future generations of consultants will greatly benefit.

Mrs. Bridget Prentice

Is the Secretary of State aware of public alarm at the number of casualty departments being temporarily closed—including at least five in London? Is she further aware of concern that—

Hon. Members

Order.

Madam Speaker

Order. The question has already been widened.

Mrs. Prentice

Is the Secretary of State aware that those closures might be due to staff shortages or, more likely, to the Government's policy of permanently closing casualty departments? What guarantee can she give London in particular that such closures will not recur?

Mrs. Bottomley

The hon. Lady identifies an area of special focus—accident and emergency departments—in which there has been an 11.1 per cent. increase in consultant appointments because it is moving towards a consultant-led service. That is precisely what underpins the move to larger A and E departments associated with minor injury centres. Junior doctors will increasingly want to staff areas that offer an A and E service according to best practice—well staffed, well equipped and of significant size.

I am sure that the hon. Lady is aware that the Royal College of Surgeons commented recently that placement in an A and E department is not necessary for training. As a result, we are holding discussions with professional groups to ensure that those jobs continue to be attractive. Our job must be to ensure top quality, well-staffed, well-equipped A and E departments for the people of this country.

Mr. Heald

Does my right hon. Friend agree that consultant numbers have increased well ahead of target? Will she join me in congratulating North Hertfordshire NHS trust based at Lister hospital on the appointment of a new audiology consultant in September which, together with the new magnetic resonance imaging scanner later this month, will make a huge contribution to improved patient care for my constituents?

Mrs. Bottomley

I join my hon. Friend in congratulating his trust, which is a classic example of how trusts have used the opportunities of their status to improve patient services and make them more responsive. I confirm that there have been an extra 300 consultants a year for the last four years. We intend to maintain and improve that impressive record.